解剖游离保留面神经应用于腮腺肿瘤手术的临床体会

目的：探讨解剖游离保留面神经在腮腺肿瘤切除术中的临床应用。方法：对本科2008年1月-2013年12月进行解剖游离保留面神经加全腮腺及肿瘤切除术的20例患者的临床资料进行分析研究。结果：面神经主干平均直径约1 mm,有5分支如丝线。术后3 d面神经轻度不全麻痹18例,术后7 d恢复8例,术后2个月内恢复8例。随访3个月-2年,其中1例因切断面神经下颌缘支行吻合术的患者,半年后恢复;1例损伤面神经颧支,左眼睑闭合无力;味觉出汗综合征1例;耳垂麻痹18例,1年后恢复;无腮腺漏,无肿瘤复发。结论：复发性、多发性以及深叶腮腺肿物行解剖游离保留面神经的全腮腺及肿瘤切除术,并发症少,临床治疗效果满意。

Clinical Experience of the Anatomic Preservation of Facial Nerve in Operation of Parotid Gland Tumors

Objective：To investigate the clinical application of the anatomic preservation of facial nerve in parotid gland tumor free resection surgery. Method： The clinical data of 20 patients with the the anatomic preservation of facial nerve and parotid gland and tumor total resection were analyzed in our department from December 2008 to January 2013.Result：The average diameter of facial nerve trunk was 1 mm, there were 5 branches such as silk. The 3 day postoperative facial nerve mild incomplete paralysis had 18 cases, 8 cases were recovered after operation for 7 days, postoperative recover within 2 months in 8 cases, follow-up with 3 months to 2 years, of which 1 cases because of cutting the nerve anastomosis in patients with marginal mandibular branch, after six months recovery; 1 cases of injury of the zygomatic branch facial nerve, the left eyelid closure weakness; 1 cases of gustatory sweating syndrome; 18 cases of earlobe paralysis, 1 years after the recovery of parotid gland; there were no leakage, no tumor recurrenced.Conclusion：Recurrent, multiple and deep lobe parotid masses dissected free of parotid gland and facial nerve preservation of tumor resection, fewer complications, satisfactory curative effect.